Did you know that we spend roughly 2,208 hours on the toilet in our lifetime? That’s a lot of time on the potty! And, if you’re having trouble going No. 1, it could be costing you even more time than you like. Time spent anywhere else but a bathroom stall.
If you have trouble starting the flow of urine when you feel you need to, and your bladder is full, you may have urinary retention. Urinary retention is the inability to pass urine in your bladder, and it can be acute—a sudden inability to urinate—or chronic—a gradual or slow inability to empty the bladder.
“The difference can be from the cause and sometimes the symptoms,” said James Wolach, MD, a urologist at Banner Health Clinic in Colorado. “Acute is usually painful and they have the sensation to void but can’t, whereas many people with chronic retention don’t have any feeling they are not able to completely empty their bladders. While chronic may not seem as serious, it can lead to serious problems, so it’s important that both receive attention from your doctor.”
There are many different causes for urinary retention in both men and women, and much of your treatment will depend on the underlying cause. Here are five reasons you may be stuck and ways to improve your flow.
Five causes for urinary retention
1. Chalk it up to age
We all want to age gracefully, but getting older still comes with some challenges, particularly for men over 50. In men, the urethra may be constricted by an prostate enlargement, also called benign prostate hyperplasia or BPH, a very common condition.
“This can cause a host of symptoms, including incomplete emptying, increased urinary frequency, urgency and even nighttime urination,” Dr. Wolach said. “These symptoms can be frustrating for some patients while others just chalk it up to age. Either way, you should discuss your symptoms with your doctor or urologist.”
Although less common, women can experience urinary retention as well. One common cause in women that’s related with age is a result of a pelvic prolapse, from weakened muscles and supportive tissues between a woman’s bladder and vagina or rectum and vagina.
2. Taking certain medications
Believe it or not, some medications may also contribute to your inability to pee. Various drugs that treat allergies, muscle pain, anxiety or depression, such as antihistamines, decongestants and some muscle relaxing medications, may cause urinary retention.
3. As a result of surgery
If you’ve just had surgery, you may experience urinary retention. During surgery, anesthesia is often given to block pain signals, and IV fluids are given to compensate for possible blood loss. This combination may result in a full bladder and impaired nerve function. Typically, it returns after anesthesia wears off, but for some, it can cause urinary retention.
4. Nerve disease and spinal cord injuries
Urinary retention may also be caused by a problem with the nerves that control the bladder. If the nerves are damaged, your brain may not be getting the signal that your bladder is full. Some causes for nerve damage include:
- Vaginal childbirth
- Stroke
- Diabetes
- Multiple sclerosis
- Parkinson’s disease
- Brain or spinal cord injuries
5. Other potential causes
While we’ve listed some of the most common, there are a number of other things that can narrow or block your urethra or bladder and contribute to urinary retention:
- In men, prostatitis, or a prostate infection, can cause swelling that blocks the flow of urine.
- Recurring urinary tract infections can cause swelling.
- Bladder, kidney and urinary tract stones can become lodged and block the opening of the urethra.
- Hard stools in the rectum due to constipation can push against the bladder and urethra, causing the urethra to pinch, making it more difficult to poop.
- Although rare, tumors and cancerous tissues in the bladder and urethra can obstruct your flow.
What symptoms should I look out for?
While the symptoms of acute urinary retention are pretty apparent (i.e., pain, discomfort and the inability to pee), some people with chronic urinary retention may not have any symptoms at all. That’s why it’s important you don’t skip your regular well checks with your doctor, who can review your medical history, run bloodwork and a urinalysis to evaluate you for any symptoms.
How is urinary retention treated?
The treatment for chronic urinary retention will depend on the root cause. If your doctor believes you may have urinary retention, they may recommend:
- A physical exam
- A urine analysis
- A Foley catheter to drain the bladder
- An X-ray or CT scan
- A change in your medication
If it’s BPH, your doctor may recommend medications to control the size of your prostate or surgery such as transurethral resection of the prostate (TURP) to remove part of the prostate. For women with a pelvic prolapse, physical therapy (pelvic floor therapy) and other exercises (such as Kegels) are typically pursued first as conservative measures before surgery is considered.
When should I seek medical care?
If you are experiencing acute symptoms, see your doctor right away, so they can start treatment and resolve the problem quickly.
Whether it's a short-term or long-term issue, don’t let urinary retention stop your flow. To find a Banner Health specialist near you, visit bannerhealth.com.
